Nicholas S. Gravbrot, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

12974694-1205 Issued in UT

Practice address

1950 Circle of Hope Dr RM 1570
Salt Lake City, UT 84112-5500

Phone

(801) 581-5498

NPI assigned

Mar 29, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1871171314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR RM 1570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500",
            "telephone_number": "801-581-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 CIRCLE OF HOPE DR RM 1570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125500",
            "telephone_number": "801-581-5498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5169 S Cottonwood St Ste 303",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841076768",
            "country_code": "US",
            "telephone_number": "801-507-3750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVBROT",
        "first_name": "NICHOLAS",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "UT",
            "license": "12974694-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan E. Grant, L.C.S.W.
• Matthew Ryan Grantz, M.D.
• Emma Gratteau, APC
• Elizabeth A Graul, M.D.
• Tracy Janelle Gravano
• Jacquelyn Gravelle, DPT
• Lisa Marie Gravelle, M.D.
• Abigail Graves
• Catherine Christensen Graves, LMHC
• Cheryl Lynne Graves, CSAC

• Radiation Oncology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Radiation Oncology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.